June 3, 2021

Dr. Tedros Adhanom Ghebreyesus
World Health Organization
Avenue Appia 20
1202 Geneva

Dear Dr. Adhanom Ghebreyesus,

We write to you today to express our deep concern regarding the recent election of Syria to a three-year term as a member of the World Health Organization’s (WHO) Executive Board. We strongly oppose the seating of this government on the board, given its appalling record of 10 years of deliberate, widespread, and systematic attacks on Syrian health facilities and personnel, and clear evidence of discrimination in the delivery of health care, including prevention and treatment during the COVID-19 pandemic.

As you are well aware, members of the Executive Board take part in the advice and implementation of the World Health Assembly’s decisions, policies, and resolutions. The most recent session of the Executive Board that started yesterday includes discussion of WHO reform, the process for the election of the Director-General, and revision of programmatic and financial reports. Such discussions are of critical importance as WHO seeks to carry out its lifesaving mission worldwide. Consequently, these meetings should be reserved for Member States with the highest qualifications and international standing, in order to positively engage and properly represent the best of the health sector at the international level.

Disastrously, the past decade of conflict in Syria has featured systematic targeting of health care and weaponization of humanitarian assistance. Your own colleagues within the UN system, as well as respected human rights organizations, have documented hundreds of attacks on health in Syria – 90 percent of them attributable to the Syrian government and/or its allies. As of March 2021, Physicians for Human rights (PHR) has documented 599 attacks on at least 350 separate health facilities and documented the killing of 930 medical personnel. From March 2011 through March 2021, 540 of these attacks have allegedly been committed by the Syrian government and its allies.[1] While efforts have been made to limit further attacks on health, including the adoption of UNSCR 2286 and the establishment of a Humanitarian Notification System for prevention of attacks on humanitarian facilities in Syria, the attacks have continued. According to the Safeguarding Health in Conflict Coalition, in the period following the adoption of UNSCR 2286, there were 442 documented attacks on health facilities in Syria alone.[2]

The Syrian government continues to violate Syrians’ right to health in some areas of the country, such as Daraa in southern Syria. Daraa is a reconciled area, where the government regained control of the province after a military escalation followed by a reconciliation agreement with opposition forces. The agreement included a commitment from the government to take all the measures required to restore basic services and infrastructure. But according to a recent report published by PHR, the people of Daraa are still suffering from intentional neglect and purposeful obstruction and denial of their right to have safe access to health care services.

When it comes to the ongoing COVID-19 response, the Syrian government has not been transparent about the real number of positive cases and the distribution of vaccines. There are growing concerns that the government is not equitably distributing COVID-19 vaccines that it recently received through COVAX, the global initiative aimed at equitable vaccine access. In the original planning, the Syrian government was to be responsible for sending vaccines into northeast Syria. However, health authorities in the area have not been included in any coordination discussions with the Ministry of Health, and the full amount of promised doses has yet to arrive. Instead, your WHO colleagues on the ground report that 17,500 vaccinations have arrived in the northeast, but it is unclear how the vaccination rollout will proceed, the number of doses available and at which facilities, the timeline for completing vaccinations, and other elements critical to planning and implementation. There is also ambiguity about whether the health workers working with local authorities and NGO partners will have any access to these vaccines.

Syria’s standing with other international bodies has also recently come into question. In April 2021, the Twenty-Fifth Session of the Conference of the States Parties to the Chemical Weapons Convention adopted a decision to suspend certain rights and privileges of Syria under the Convention. This was a result of the Organisation for the Prohibition of Chemical Weapons’ (OPCW) Investigation and Identification Team concluding that there are reasonable grounds to believe that the government of Syria has used chemical weapons. It also expressed deep concern that the government has failed to declare and destroy all of its chemical weapons and production facilities.

As a result of this decision, the government of Syria had the following rights and privileges suspended:

a) To vote in the Conference and the Council; b) To stand for election to the Council; and c) To hold any office of the Conference, the Council, or any subsidiary organs. We strongly urge the WHO to consider taking measures similar to those adopted by the OPCW and decline the right of the government of Syria to stand for elections to leadership positions within the WHO. It is all the more alarming that Syria’s representative on the Executive Board, Dr. Hassan al-Ghabbash, is on the list of Financial Sanctions Targets in the UK.[3]

Based on all of the above, we are seeking your urgent attention to this issue. We call on you, as Director-General, to denounce Syria’s election due to documented evidence of attacks on health and violations of WHO’s core values. Failing to speak out would be to dishonor the more than eight hundred health care workers who were killed due to direct targeting by the Syrian military and its allies. Although we recognize you do not have direct authority in the selection of Executive Board members, we strongly believe that you should take a similar stance to when you revoked the appointment of Zimbabwe’s Robert Mugabe as a goodwill ambassador for the WHO[4] after listening to the concerns and constructive debates raised at the time.

As you yourself forcefully stated: “For me, what is important is to build political leadership and create unity around bringing health to all, based on WHO’s core values.”

We also call for additional procedures to be put in place in order to prevent such an incident from occurring in the future. Specifically, we recommend that: 1) All elections to the Executive Board undergo a formal, public vote by the Members of that particular region; 2) No country may qualify for election to the Executive Board if it has been determined by a United Nations body to have violated International Humanitarian or Human Rights Law in the period preceding the previous election cycle, and 3) Any candidate for the Executive Board must first receive certification from the WHO Secretariat that it is in compliance with WHO’s core values.

We call on you to do everything in your power to overturn the election of Syria to the WHO Executive Board. This is critical in order to maintain the international credibility of the WHO and to send the strongest message possible to the people of Syria and the community of nations that extreme and overt violations of the right to life and health, including targeted attacks on health systems themselves, will not be rewarded.

Thank you for your kind attention to this urgent matter. We look forward to continuing to support the work of WHO in accordance with its core values.


Donna McKay
Executive Director, Physicians for Human Rights

Dr. Mufaddal Hamadeh
President, Syrian American Medical Society 

[1] Physicians for Human Rights, “Findings of Attacks on Health Care in Syria,” updated as of March 2021, http://syriamap.phr.org/#/en/findings.

[2] Safeguarding Health in Conflict Coalition, “Ineffective Past, Uncertain Future: The UN Security Council’s Resolution on the Protection of Health Care: A Five-year Review of Ongoing Violence and Inaction to Stop It,” May 2021, http://insecurityinsight.org/wp-content/uploads/2021/05/Ineffective-past-Uncertain-Future-A-Five-Year-Review-2016-2020.pdf.

[3] HM Treasury, Office of Financial Sanctions Implementation, Consolidated List of Financial Sanctions Targets in the UK, updated as of March 25, 2021, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/973238/Syria.pdf.

[4] World Health Organization, “Director-General rescinds Goodwill Ambassador appointment,” October 22, 2017, https://www.who.int/news/item/22-10-2017-director-general-rescinds-goodwill-ambassador-appointment.